ABSTRACT
Pseudomonal eyelid necrosis is a rare condition that has not been well characterized. Five case reports have been previously described. The authors present an additional case, describe its unique features, review the previous reports, and establish the clinical characteristics of the disorder. Pseudomonal eyelid necrosis always occurs in the setting of neutropenia. It may be unilateral or bilateral, and is managed with wound debridement, intravenous and local antibiotics, and, most important, restoration of the neutrophil count. A delay in diagnosis and treatment may lead to functional impairment and cosmetic disfigurement. Although not previously reported in association with eyelid necrosis, uncorrected neutropenia in association with pseudomonal soft tissue infection elsewhere in the body has been associated with septicemia and death. Familiarization with the salient features of the disorder allows prompt therapeutic intervention and may prevent potentially serious complications.
Subject(s)
Eye Infections, Bacterial/microbiology , Eyelid Diseases/microbiology , Eyelids/pathology , Pseudomonas Infections/microbiology , Anti-Bacterial Agents , Drug Therapy, Combination/therapeutic use , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Eyelid Diseases/diagnosis , Eyelid Diseases/drug therapy , Eyelids/microbiology , Female , Follow-Up Studies , Humans , Middle Aged , Necrosis , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/isolation & purificationABSTRACT
Uveal melanoma cell cycling, quantified by bromodeoxyuridine (BrdUrd)-labeling index and mitotic index, is predictive of tumor-related mortality. Serial sections from 36 formalin-fixed melanoma specimens were labeled with BrdUrd and stained with hematoxylin and eosin. All tumors were assessed for the area of highest cell cycling activity and counts for mitotic figures and BrdUrd labeling were performed in these areas in a masked manner. The BrdUrd labeling index and mitotic index were calculated and analyzed in relation to tumor-related mortality and histopathological criteria (largest tumor diameter, cell type, extra-scleral extension, ocular location). Cox multivariate analysis estimated an increased relative risk of tumor-related mortality of 2. 32 (95% confidence interval, 1.22-4.41) per doubling of BrdUrd labeling index and 2.41 (95% confidence interval, 1.29-4.49) per doubling mitotic index. Larger tumors, nonspindle cell tumors, and anterior-located tumors tended to have higher cycling rates.
